MEDICAID is a joint federal and state program.
Medicaid may help you pay medical costs if you have limited income and resources and meet other requirements. Some people are “dual eligibles,” which means they qualify for both Medicare and Medicaid.
If you have Medicare and full Medicaid coverage, most of your health care costs are covered. Medicare covers your Part D prescription drugs. Medicaid may cover some drugs plus other care that Medicare doesn’t cover.
People with Medicaid may get coverage for services that Medicare may not cover or only partially cover, like nursing home care, personal care, as well as home and community-based services.
Click here to learn how Medicaid works with Medicare.
MEDICARE SAVINGS PROGRAMS (MSP) are available for those who have limited income and resources.
The following 4 state programs help people pay for Medicare premiums, and when certain conditions are met, may also pay Medicare Part A and B deductibles, coinsurance, and copayments for Medicare-covered items and services.
QMB: Qualified Medicare Beneficiary Program
• Helps pay: Part A premiums, Part B premiums, deductibles, coinsurance, and copayments
SLMB: Specified Low-Income Medicare Beneficiary Program
• Helps pay: Part B premiums
QI: Qualifying Individual Program
• Helps pay: Part B premiums
NOTE: You can’t get QI benefits if you qualify for Medicaid. You must apply every year for QI benefits. Applications are granted on a first-come, first-served basis, with priority given to people who got QI benefits the previous year.) If you qualify for a QMB, SLMB, or QI program, you automatically qualify to get Extra Help paying for Medicare prescription drug coverage. (See Extra Help below.)
QDWI: Qualified Disabled and Working Individuals Program
• Helps pay: Part A premiums. You may qualify if ANY of these apply to you: you’re a working disabled person under 65, you lost your premium-free Part A when you went back to work, you aren’t getting medical assistance from your state, OR you meet the income and resource limits required by your state. Resources include money in a checking or savings account, stocks, bonds, mutual funds, and Individual Retirement Accounts (IRAs). Resources do not include your home, one car, burial plot, burial expenses up to your state’s limit, furniture, or other household items.
NOTE: If you have income from working, you may qualify for benefits even if your income is higher than the limits listed above. (Limits are slightly higher in Alaska and Hawaii.)
Click HERE to learn about the income limits and resource limits for each of the four Medicare Savings Programs, or call Medicare at 1-800-MEDICARE (1-800-633-4227). For TTY assistance, call 1-877-486-2048.
Click HERE to go to talk to someone via Medicare Live Chat. This service is available 24-hours a day, 7 days a week, except for some federal holidays.
EXTRA HELP is a federal program that helps people with limited income and resources pay Medicare prescription drug costs.
To qualify for Extra Help you must have:
- Medicare Part A (Hospital Insurance) and/or Medicare Part B (Medical Insurance)
- You must be enrolled in (or will be enrolled in) a Medicare Part D plan; either a stand-alone Part D plan or one that is part of a Medicare Advantage plan
- A U.S. Citizen or legal resident (includes the 50 states or the District of Columbia)
Click HERE to learn about the income limits to be eligible for this program. and how much you will pay for your medications if you qualify for Extra Help.
For more information about Extra Help, download “Understanding the Extra Help With Your Medicare Prescription Drug Plan” [PDF]
State Pharmacy Assistance Program (SPAP)
Some pharmaceutical companies offer programs to help pay for prescriptions for people in a Medicare Drug Plan (Part D).
Click here to find a Pharmaceutical Assistance Program for the drugs you take.
PACE (Program of All-Inclusive Care for the Elderly) is a Medicare/Medicaid program that helps people meet healthcare needs in the community.
With this Medicare + Medicaid program, a team of healthcare professionals will provide coordinated care to help you meet your healthcare needs at home, instead of in a nursing home or elderly care facility.
Click HERE to find a PACE plan in your area. (Not available in all areas.)
Note: Financial aid programs may vary from state to state.
If you have questions about Medicare or other life & health insurance products, click here to contact Linda Bell, a licensed independent insurance broker at Heart to Heart Insurance Agency, LLC, in Las Vegas, Nevada.
